| NPI | 1730967290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI WALDRON Owner, Therapist 920-815-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2023-09-18 |